I recently had a cardiac event. Do I need to continue wearing this very uncomfortable defibrillator vest?

I am currently seeing a cardiologist for a recent heart failure episode. After this event, the cardiologist on staff at the hospital where I went for this emergency ordered a Zoll life vest for me to wear. It has been two months since the event and my ejection fraction is still 30-35% but I am on medicine for this problem. Do I really need to wear this very uncomfortable machine daily? I have lost weight since I began this treatment.

Marianne, An ejection fraction of less than 30 or 35% (depending on the underlying cause and depending on the study) places you at an increased risk of sudden cardiac death from ventricular fibrillation. This is the primary indication for an implantable defibrillator. However, guidelines suggest waiting at least 3 months before implanting a permanent device since some cardiomyopathies can improve. We commonly recommend wearable defibrillators during this waiting period. They are notoriously uncomfortable. The decision to wear is all about mitigating risk. While the daily risk of an event is low, it does add up over weeks and months and we are unable to predict who will have an event or when it might happen. Since the "event" is death, we usually have a very low tolerance! Even though many people wear these defibrillators and they do not have events, there are also people who are saved every week because a wearable defibrillator was in place and shocked their heart back from what would have been a terminal event.

Hopefully, you will either improve or move to definitive therapy soon. Although losing weight and being on appropriate medical therapy are laudable achievements and do change your risk of recurrent heart failure, they do not have much effect on this particular aspect of your illness.